Inspection on 12/04/07 for Grange Park Avenue, 18

This inspection was carried out on 12th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grange Park Avenue, 18 09/12/05

Grange Park Avenue, 18 17/08/05

Grange Park Avenue, 18 31/01/05

Grange Park Avenue, 18 27/07/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Grange Park Avenue, 18 18 Grange Park Avenue Bedlington Northumberland NE22 7EF Lead Inspector Anne Brown Key Unannounced Inspection 12th and 17th April 2007 10:00 Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Park Avenue, 18 Address 18 Grange Park Avenue Bedlington Northumberland NE22 7EF 01670 - 530544 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) NTAWNT.GrangePark@nhs.net Northumberland, Tyne & Wear NHS Trust Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 residents are over the age of 65 years Date of last inspection 9th December 2005 Brief Description of the Service: 18 Grange Park Avenue is a semi-detached house situated in a residential estate on the outskirts of Bedlington. The home is registered to provide accommodation for three residents with learning disabilities, two of whom are over 65 years of age. Northumberland, North Tyneside and Newcastle NHS Trust provide the service and the property is rented from Wansbeck District Council. The ground floor accommodation consists of a lounge, kitchen/dining room and one bedroom with an en-suite facility. On the first floor there are two bedrooms, a bathroom and a staff sleep-in room/office. There is a small garden to the front and a large garden to the rear of the house. The fees range from £991.00 to £1007.76 per week. Inspection reports and information about the home are readily available. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five hours. A tour of the premises took place and a sample of records was inspected. These included care plans, fire log, accident book, complaints, minutes of meetings and medication records. Staffing records were examined at the Human Resources Department at Northgate Hospital. One member of staff and two residents were spoken to during the inspection. A second visit was made to the service to speak to the manager. She is not yet registered with the Commission. Questionnaires were sent to the residents and their relatives. All three residents returned questionnaires. No questionnaires were received from the relatives. What the service does well: The staff team are committed to providing a good standard of care to the people using the service. The staff member on duty was respecting privacy and dignity and dealing with individual needs in a competent and caring manner. The staff encourage and support people to pursue a wide range of activities and a vehicle is provided to transport them to venues of their choice. The two residents who were spoken to said they liked living in the home and they had good relationships with the staff. They said the food was good and they were given plenty of choice. They also indicated that they knew how to complain if they needed to. Regular meetings take place to consult the residents regarding the day-to-day running of the home. This included activities, décor and menus. The staff offer the residents choice in all aspects of their lives and encourage and support them to keep in touch with family and friends. The staff team are offered a wide range of training courses that include mandatory health and safety training and a range of specialist courses to ensure they are competent to deal with the residents’ needs. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available for prospective residents to help them decide where to live. Residents have their individual needs assessed prior to admission. This ensures that the staff are aware of their needs and are able to meet these. EVIDENCE: The Statement of Purpose and the Service Users Guide both contained the full range of information required. This helps prospective residents to decide if the home is able to meet their needs. One resident interviewed confirmed he had been given a copy of the guide. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 9 The home conducts a thorough pre-admission assessment. This includes obtaining the Care Management Assessment and information is sought from carers/relatives and relevant health care professionals. Copies were available on the individual case files so staff can refer to these to ensure individual needs are met. No admissions have been made to the home since the last inspection. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are care plans that contain guidelines, which explain what staff need to do. However some evaluations were out of date, which may mean some information is not correct. Residents are encouraged to make decisions and take risks. EVIDENCE: Two service users confirmed that they are consulted about any decisions made in their lives. Evidence was available from the records and talking to the staff, that service users are encouraged to make individual choices and handle their own money. The minutes of the house meetings confirmed that redecoration, food, outings and holidays are discussed. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 11 Comprehensive risk assessments are available on the case files. These assist the residents to lead fulfilling lives and they are well supported by staff to take calculated risks as necessary. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff make every effort to ensure residents have links with the community and opportunities to participate in social and personal development activities. However residents cannot always access individual activities. Residents are encouraged to keep in touch with family and friends. Residents’ rights are respected in all aspects of their lives. Meals are varied and healthy eating is encouraged. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 13 EVIDENCE: The staff team make every effort to ensure the residents are able to take part to appropriate activities and access facilities within the local community. A vehicle is provided to escort residents to venues of their choice. However during the last few weeks only one member of staff has been on duty on many occasions due to staff shortages. This means that the residents have been unable to enjoy activities on an individual basis. On the second visit to the service the manager confirmed that a temporary member of staff has been allocated to work in the home. This means that two or three members of staff will be on duty during the day. However the manager was unsure how long this could continue if the temporary member of staff is removed. Therefore residents will not be able to participate in individual activities of their choice. Residents are encouraged and assisted to keep in touch with friends and relatives. The staff and one resident confirmed that residents could invite friends and family to the home. They can also choose who they wish to see and can entertain their visitors in private. The residents’ rights are respected and they are encouraged to make choices. Polling cards have been received to enable the residents to vote in the forthcoming political election. Menus are planned on a four weekly basis and residents are involved in this process. The menus are varied and nutritious. Alternatives are always available and special diets are catered for. The two residents who were interviewed said they enjoyed the food served to them. They also described their favourite meals and these are included in the menus. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents have access to health care services and staff are aware of their personal health care needs. However gaps in the information means that residents’ health and personal needs may not always be met. An appropriate system is in place for dealing with medications, but does not always follow good practice which may not protect the residents. EVIDENCE: There was evidence within the residents’ care records that they have access to external health care services. The residents are registered with local GP practices and referrals are made to specialist health care services if appropriate. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 15 It is the home’s policy to ensure all residents receive a health check on an annual basis. The records for one resident showed this was over a year out of date. The system for dealing with medication was examined. This was appropriate but due to recent staff shortages, two signatures are not retained for checking medication into the home. This could place residents’ at risk. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ views are listened to and acted upon. Staff training and policies and procedures protect the residents from abuse. EVIDENCE: The home has a complaints procedure written in a way, which helps the residents understand its contents. The procedure is also available on DVD. Two residents interviewed confirmed that they had been given a copy of the procedure. They said they would feel able to make a complaint if necessary and would speak to the manager or the staff. The manager confirmed that residents’ relatives have all been provided with a copy of the homes complaint procedures. A copy of the procedure is displayed in the home so other visitors have access to this. The home does keep a record of complaints. One complaint had been received from a neighbour. Appropriate action has been taken to deal with this. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 17 The home has a whistle blowing policy and a copy of the Local Authority Safeguarding Adults Procedure. The staff member on duty was aware of the action to take if bad practice was observed. However a record was examined in the home regarding an incident between two residents. This incident had not been reported to the Local Authority and the CSCI in line with the Safeguarding of Adults Procedures. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a homely and comfortable environment for the residents to live. However some areas are showing signs of wear and tear, and need redecorating. Bedrooms are individualised and meet the needs of the residents. The shower in the en suite facility is not suitable for the resident’s needs. The residents were not living in an environment in which all areas were clean and hygienic. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 19 EVIDENCE: The living room, dining room and kitchen are homely, pleasantly decorated and clean and hygienic. The paintwork in the hall, stairs and landing was chipped and showing signs of wear of tear. The upstairs bathroom was in need of redecorating. The grouting on the tiles around the bath was discloured. The frame on the shower in the en suite was damaged. The member of staff on duty felt the resident may be leaning on this to steady himself. Therefore this could pose a potential safety hazard. The manager stated that the care manager is currently arranging for a reassessment of the equipment. Residents’ bedrooms were individualised and contained items personal to them. One resident had been given a picture for his bedroom at Christmas. This has still not been hung on the wall and the resident was eager that this should be done. Some areas of the home were dusty and the en suite facility was in need of cleaning. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team are well trained and competent to support the residents. The recruitment policy and practice supports and protects the residents. Due to staff shortages some social needs were not being fully met. EVIDENCE: All members of staff have achieved a National Vocational Qualification (NVQ), Level 2 or above. A programme is in place to ensure they undergo up to date mandatory health and safety training and specialist training. This helps them to meet the needs of the residents. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 21 The staff team have recently completed a course on dementia to help them understand and meet the needs of one resident. Two of the residents are over 65 years of age and the staff have not undergone training in working with ageing and death. An appropriate recruitment and selection process is in place. Staff files are held at the Human Resources Department at Northgate Hospital and a sample was inspected. They showed that appropriate checks are carried out prior to staff being employed, which protects the service users. Photographs were not available on the staff files for identification purposes. On the first day of the inspection one member of staff was on duty. They were responsible for cooking, cleaning, meeting the residents’ personal and health needs and their social needs. This means that individual social needs are not always met, as staff are unable to spend time with the residents. On occasions one resident is taken to visit his relative. If one staff member is on duty the other two residents have to accompany him on the journey there and back. This means they cannot access activities on an individual basis. In the past one member of staff slept in the home overnight. One resident has recently fallen and sustained a fracture and a waking night staff member has replaced the ‘sleep in’ to meet their needs. The daily recordings stated that staff had been frequently awoken to attend to two residents due to their changing needs. Evidence in the recordings and a conversation with the staff member on duty shows there is a need for a ‘waking night staff member’ to be on duty on a permanent basis. A conversation was held with the manager during the second visit to the home. She is well aware of the above problems and is discussing this with her line manager. An extra member of staff has now been supplied to the home on a temporary basis. The staff member was observed to be dealing with the residents’ in a competent and sensitive manner. Good relationships were observed and the staff member was well aware of the residents’ individual needs. The staff member confirmed that they receive up to date training in health, safety and specialist issues. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well run with a focus on the residents. The management and staff team respect the residents’ views regarding the running of the home. The health, safety and welfare of residents are generally protected by the systems the home has in place. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 23 EVIDENCE: Since the last inspection the registered manager has transferred to another home run by the Trust. Another manager has been appointed who has previous experience in managing care homes for people with learning disabilities. Staff and residents said the new manager was approachable and supportive. Meetings are held in the home on a regular basis. The minutes showed that residents are asked their opinion on the day-to-day running of the home. The fire log book showed that the fire safety equipment is tested at the appropriate intervals. This helps to ensure the service users’ safety. Up to date safety test certificates could not be found for the fire extinguishers, gas installation, emergency lighting, fire alarm and electrical installation. The manager confirmed the above tests had taken place and would forward the certificates to the Commission when these are obtained from head office. One resident was observed to be moving fire extinguishers on the upstairs landing as there is no place to secure this to the wall. The manager stated she would contact the fire officer to receive the best advice as to where the extinguisher should be held. In the period leading up to the first visit, while the manager had been absent, the management cover had not adequately assessed staffing levels. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 3 X X 2 X Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard YA6 YA19 YA20 YA23 Regulation 15(2)(b) Requirement Timescale for action 31/07/07 31/05/07 31/05/07 31/05/07 5. 6. YA27 YA27 7. 8. 9. YA30 YA33 YA42 YA42 Care plans must be reviewed and updated. (Previous timescale of 31/1/06 not met). 12(1)(a) The residents’ health needs must be fully recorded in their case files. 13(2) Two staff signatures must be retained when medications are received into the home. 13(6) Safeguarding issues must be reported through the correct procedures to protect the residents. 23(2)(d) The upstairs bathroom must be redecorated and the grouting on the tiles must be cleaned. 23(2)(n) The en suite shower must be made safe and a reassessment carried out on the resident’s needs. 23(2)(d) All areas in the home must be clean and hygienic. 18(1)(a) Sufficient staff should be on duty at all times to meet the individual needs of the residents. 24(4)(c)(i) Advice to be sought from the fire officer regarding a safe location for the fire extinguisher. 31/08/07 31/05/07 31/05/07 31/05/07 31/05/07 Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3. 4. Refer to Standard YA14 YA24 YA32 YA34 Good Practice Recommendations The home should ensure that residents are able to participate in individual activities. The paintwork in the hall, stairs and landing should be renewed. Staff to be given training on working with ageing people and death. Photographs to be kept on all staff files for identification purposes. Grange Park Avenue, 18 DS0000000572.V330147.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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